Navigating the Trachea: New Formula for Indian Children

Excerpt

In children, a short trachea coupled with a narrow margin of safety makes correct placement of the endotracheal tube (ETT) difficult [1]. Incorrectly placed ETT is wrought with several complications, important among them being accidental extubation and bronchial intubation [2]. According to Matsuoka et al. 23.5% of Pediatric Intensive Care Unit (PICU) intubations had incorrect ETT depth [3]. Rivera and Tibballs showed that accidental extubations accounted for 23% of intubation-related complications among infants and children in a PICU [4]. The depth of insertion for orotracheal intubation (in cm) is traditionally calculated using equations based on age (Cole's formula, adopted by APLS) [5], weight, and height (Morgan and Steward formulae) [1]. However, given the ethnic and nutritional differences across the globe, a "one size fits all" approach for calculating the size and depth of ETT insertion may not be optimal. …